Individual
ELOISA OQUENDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1118 BERKLEY RD, GIBBSTOWN, NJ 08027-1608
(856) 366-8869
Mailing address
1118 BERKLEY RD, GIBBSTOWN, NJ 08027-1608
(856) 366-8869
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
0450545807
NJ
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450545807
—
NJ
05
—
20266580476
—
NJ
Enumeration date
10/01/2020
Last updated
10/01/2020
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